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WALGREEN CO.
CH09071AX Community Health Centers Of The Central Coast, Inc.
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Covered Entity Details
Entity Name
Community Health Centers Of The Central Coast, Inc.
Subdivision Name
COMMUNITY HEALTH CENTERS - ARROYO GRANDE
Type
HRSA-Funded Health Center
340B ID
CH09071AX
Entity Address
1205 E. Grand Ave., Ste H
Arroyo Grande, CA 93420
Grant Number
H80CS00621
Participating Start Date
7/1/2018
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06290
937 NORTH H STREET
LOMPOC, CA 93436-4148
Pharmacy Comments
Contract Details
Approval Date
6/9/2023
Contract Begin Date
6/9/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
RONALD E. CASTLE, CEO
(805) 459-1835
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
6/9/2023
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